Health & hygiene

224 million people reached by end 2012

Our commitment

By 2020, we will help more than a billion people to improve their hygiene habits and we will bring safe drinking water to 500 million people. This will help reduce the incidence of life-threatening diseases like diarrhoea.

Our performance

224 million people reached by end 2012.

119 million people with Lifebuoy; 45 million with safe drinking water from Pureit; 49 million with our toothpaste brands; and 11 million through Dove Self-Esteem programmes.

What matters most

For the  Heath & Hygiene commitment we have two targets that are most material to us: Reduce diarrhoeal and respiratory disease through handwashing and Provide safe drinking water. (M) indicates our most material targets.

  • achieved: 0
  • on-plan: 5
  • off-plan: 0
  • %of target achieved: 0

Our perspective

Poor hygiene, lack of safe drinking water and poor sanitation are the cause of millions of preventable deaths.

These issues are closely interconnected. Evidence shows that individuals will be healthier and communities more productive if they have access to clean water and better sanitation and if they adopt improved hygiene practices.

Using our products to improve hygiene and well-being

Unilever brands can play an important role here. We make effective, affordable products that improve health, hygiene and well-being. As one of the world’s leading consumer goods companies, we can use our expertise in marketing and delivering campaigns to reach large, diverse populations and achieve a lasting impact on everyday behaviours.

One brand which demonstrates this is Lifebuoy soap. It is also one of Unilever’s fastest-growing brands – it has achieved double digit-growth over 2010-12. It is a good example of how brands that help to address social challenges can build brand equity and grow their business.

We have made good progress towards our goal. Lifebuoy and Dove have extended existing partnerships and developed new ones. Our oral care brands are set to meet their target much earlier than planned. We have also gained a better understanding of the impact of our handwashing programmes.

We have started to explore how we can develop a more systematic approach to water, sanitation and hygiene issues by piloting a sanitation programme between our Domestos toilet cleaner brand and partners UNICEF and the World Toilet Organization. This will enable us to take a more systematic approach to improving health through a concerted effort around clean water, sanitation and hygiene in future.

The biggest challenge we face across all our targets is to scale-up programmes cost-effectively. Forming the right partnerships with governments, NGOs and other experts is helping us. But to reach our ambitious targets, we need to move faster to widespread implementation.

Lifebuoy targets countries with high child mortality

During 2012 Lifebuoy launched handwashing programmes in seven new countries: Egypt, Ghana, Nigeria, South Sudan, Uganda, Zambia and Zimbabwe.

Our behaviour change programmes are now running in 16 countries, reaching eight of the top ten countries most affected by child mortality.

A lower-cost model for our schools' programmes

Teenagers in a South African SchoolLifebuoy has ambitious plans to scale up the reach of its school hygiene promotion programmes in Africa. However, in some countries the brand has been launched or re-introduced only recently and is still a relatively small brand. A multi-brand programme is more cost-efficient and is an opportunity to connect people to more of our brands that have a social impact.

Our Central African business and Lifebuoy have piloted a programme with our Close Up toothpaste and Blue Band margarine brands in Nigeria and an external partner, D.lite, which produces solar lanterns to enable children to do homework after dark.

The 21-day programme uses multiple classroom contacts to help children practise new behaviours: handwashing with soap, brushing teeth day and night, and eating well. We have been able to reduce our cost per contact significantly by sharing costs across brands. The programme has huge potential for roll-out in other countries in Africa. Schools, governments and NGOs support this approach as, by promoting a number of healthy behaviours together, it has the potential to deliver significant health impact at lower cost.

Domestos tackles sanitation crisis

Man building in VietnamMore than 2,000 children die every day from diarrhoea, which is linked, among other things, to a lack of clean toilets for over 2 billion people worldwide.

In November 2012, Domestos and our partner, the World Toilet Organization, opened the world’s first ‘Domestos toilet academies’ in Vietnam, the first stage in a global programme to train local entrepreneurs to set up hygienic toilet businesses.

The academies leverage the ’SaniShop’ business model developed and proven by the World Toilet Organization in Cambodia. Training local entrepreneurs to supply latrines, toilet cleaner and sanitation education is an innovative market-based model which creates demand for improved sanitation within local communities and provides jobs.

Our Five Levers for Change Model

Encouraging people to adopt new behaviours is essential if we are to achieve our goals.

Underpinning our approach is our model of behaviour change, Unilever’s Five Levers for Change – a set of principles which, if applied consistently, increases the likelihood of creating a lasting impact.

We first used this model to develop our behaviour change programmes with Lifebuoy soap and our oral care brands. We have learned a great deal through our health and hygiene campaigns and we are now applying the methodology to improve our performance in other areas, for example we are using it to understand how we can motivate consumers to reduce their salt intake.

Reduce diarrhoeal and respiratory disease through handwashing (M)

  • By 2015, our Lifebuoy brand aims to change the hygiene behaviour of 1 billion consumers across Asia, Africa and Latin America by promoting the benefits of handwashing with soap at key times.

  • 119 million people reached since 2010, of whom 71 million were reached in 2012.†

More on reducing diarrhoeal and respiratory disease through handwashing

Our Perspective

The major challenge we face is scaling up our handwashing programmes cost-effectively. Since 2010, we have made strong progress, developing models which more than halve the cost. We have expanded the programme to 16 countries in 2012 and have reached five times as many people as we did in 2010. Our most significant expansion is in Africa where programmes are now running in nine countries, reaching more than 11 million people in 2012, compared to 400,000 over 2010-11. This has contributed to Lifebuoy’s continued double-digit business growth in 2012.

Partnerships with NGOs and government are critical – by tapping into existing on-ground networks and expertise we can reduce costs and reach more people. In Africa, Unilever Foundation partner PSI (Population Services International) and the Millennium Villages Project are helping us to adapt our programmes for different contexts. In India we are working with the government and Foundation partner UNICEF to promote handwashing in Madhya Pradesh and in Africa and South Asia, with Water & Sanitation for the Urban Poor. These partnerships are also building local capabilities to sustain the programmes for the long term.

We continue to evaluate impact. In Indonesia we conducted a quantitative study with TNS, a market research company, to assess impact when the programme is run at scale. We found that handwashing with soap at key occasions increased significantly after the schools’ hygiene promotion programme. Soap use increased from 53% to 75%. This increase was sustained at the same level more than six months after the programme ended.

Reaching new communities

Some communities can be difficult and costly for Lifebuoy to reach by itself. We are collaborating with the Millennium Villages Project to promote handwashing with soap in rural communities across Africa.

The project will enable us to adapt our current handwashing programme and advocacy to this setting, reaching 475,000 people across ten countries by 2015. Our aim is to work together to develop scalable, cost-effective water, sanitation and hygiene interventions which can then be rolled out at national level and to new countries, improving health through better hygiene.

The first 28 days of life is the period when children are most vulnerable to disease and infant mortality is highest. Every year an estimated 3.6 million newborn babies die in the first month of their lives. Simple, low-cost health interventions such as handwashing with soap can reduce this figure by up to 44%. In Indonesia we have developed a new partnership with USAID and the Maternal and Child Health Integrated Program to reach new mothers and birth attendants with hygiene education.

† To be independently assured by PwC in 2013

Provide safe drinking water (M)

  • We aim to make safe drinking water available and affordable to 500 million people through our Pureit in-home water purifier by 2020.

  • 45 million people have gained access to safe drinking water from Pureit since its launch in 2005, of whom 10 million were reached in 2012.†

More on Providing safe drinking water

Our Perspective

The lack of safe drinking water is a major public health issue, particularly in developing countries where around 80% of diseases are water borne. An independent study has shown that Pureit can reduce the incidence of diarrhoeal disease by up to 50%.*

During 2012 Pureit focused on distribution expansion in existing markets – India, Bangladesh, Indonesia, Mexico and Brazil – and also launched in new markets such as Sri Lanka and Nigeria.

Expansion in India was the biggest contributor to performance in 2012, where consumers have been attracted to our wider product range.

The most affordable model costs €20 (1,400 rupees) in India. We are working with a range of microfinance and NGO partners to improve the affordability of the purifier for those for whom the price remains a barrier to purchase.

Our ambition to reach 500 million people remains demanding. To achieve our target we plan to expand into more new markets in Africa, while continuing to grow in existing markets.

Safe Drinking Water

Man drinking from a Pureit machinePureit offers a range of in-home water purifiers that provide water ‘as safe as boiled’ – without the need for electricity or a pressurised water supply – by removing harmful viruses, bacteria and parasites.

Pureit offers environmental benefits too: our detailed lifecycle analysis shows that its total carbon footprint is at least 80% lower than boiled or bottled water.

† To be independently assured by PwC in 2013.*Randomised trial by the National Institute of Epidemiology, based on 430 children in Chennai, India, 2005-06.

Improve oral health

  • We will use our toothpaste and toothbrush brands and oral health improvement programmes to encourage children and their parents to brush day and night. We aim to change the behaviour of 50 million people by 2020.

  • 49 million people reached since 2010, of whom 4.7 million were reached in 2012.

More on improving oral health

Our perspective

Our Brush Day and Night campaigns have proved very effective and we are set to achieve our target early. Many additional countries ran the campaign after observing the strong link between the campaign’s social impact and business growth, helping us to reach more people than anticipated.

The campaigns, which focus on brushing twice a day with fluoride toothpaste, were extended to new countries such as Côte d’Ivoire in 2012. Countries with existing programmes such as Indonesia and France saw an improvement in brushing frequency and an increase in market share and sales growth following the campaign. In France the oral care market has grown by nearly 5% over 2009-12 and sales of our Signal brand increased by nearly 7% over 2009-12, and by 4% in 2012 alone.

We continue to work in a global partnership with the FDI World Dental Federation. In 2012, 28 local oral health promotion projects with national dental associations focused on communicating the importance of twice-daily brushing with fluoride toothpaste through dental practices, schools, hospitals and communities across 25 countries. We are evaluating the impact on over 28,000 people involved in these programmes around the world.

A new campaign in 2013 is designed to address parents as the primary target to encourage behaviour change.

Building brands

Poor oral health is a widespread problem in Indonesia. This leads to tooth decay and, in some cases, more serious illnesses. In 2009 Unilever collaborated with PDGI (the Indonesian Dental Association) to initiate the Brush Day and Night campaign.

The campaign’s consistent messages across multiple channels are helping people to change their habits. In 2012, Indonesians used 7% more toothpaste than in 2011, indicating a gradual increase in toothbrushing.

Brand equity has also strengthened. By offering parents effective products and by helping them to pass on the habit of brushing day and night, we have increased the proportion of people who rate Pepsodent as ‘the most effective toothpaste’.

Brush day and night promotes growth

Our leading family health toothpaste brands, Signal and Pepsodent, are growing strongly thanks to our Brush Day and Night oral health campaigns. Over 2008-12, Signal grew by 22% worldwide. In Indonesia, one of our biggest markets, sales of Pepsodent rose by nearly 16% in 2012 compared to the previous year.

Improve self-esteem

With our Dove brand we are helping millions of young people to improve their self-esteem through educational programmes.

  • By 2015 we aim to have helped 15 million young people.

  • Over 11 million young people have received our help since 2005. Over 2 million participated in the programme in 16 countries in 2012.

More on improving self-esteem

Our perspective

Dove is committed to helping women look and feel their best. It has made good progress in helping to raise the self-esteem of millions of young people worldwide and is on track to meet its target.

In 2012 Dove redesigned its self-esteem programme to capitalise better on media and educational innovation and reach more girls with a greater impact while reducing the costs for each intervention.

The redesigned programme – now called the Dove Self-Esteem Project – is launching in early 2013. We have worked with experts to make the programme content more rigorous and engaging. Developing global partnerships as well as creating local communities of advocates among mothers and teachers will help Dove reach more people.

It is difficult to measure changes in attitude. We are partnering with academic thought leaders in the US and the UK to conduct studies to track the longer-term impact of our programme.

Dove: our leading Personal Care brand

Woman using a Dove roll-on deodorantDove is our largest Personal Care brand, available in over 70 countries and with an annual turnover of over €3 billion. It continues to grow strongly, experiencing its third consecutive year of double-digit growth in 2012.

Dove boosts self-esteem and business success

Two teenage girls smilingPart of the success of our Dove Self-Esteem Project has been an increased willingness among consumers to spread the brand’s affirmative message and to purchase Dove’s products.

Research by Millward Brown, a research company, shows that among women in the US who are aware of the Dove Self-Esteem Project, 62% would recommend the Dove brand to others – 16% more than among those who are not aware of the project.

Among women in Canada who are aware of the project, 82% would be more likely to purchase Dove. These results motivate us to continue to invest in the Project.

Reduce workplace injuries and accidents

  • We aim for zero workplace injuries. By 2020 we will reduce the Total Recordable Frequency Rate (TRFR) for accidents in our factories and offices by 50% versus 2008.

  • 45% reduction in TRFR at end 2012 compared to 2008, down from 2.1 to 1.16† accidents per 1 million hours worked.

More on reducing workplace injuries and accidents

Our perspective

We are among the leaders in our industry on safety. Therefore the target to halve our injury rate is a stretching one and becomes progressively harder as we get closer to our aim.

We measure our progress using an accident rate (TRFR) which counts all workplace injuries except those requiring only simple first aid treatment. With the exception of 2001, we have achieved continuous improvement in our health and safety record since 1996. In 2012 we continued this progress, reducing TRFR by 9% compared to 2011†, from 1.27 to 1.16 per 1 million hours worked.

However, reducing road traffic accidents remains a priority for protecting our people. Much of our business growth comes from developing markets where our sales people are at increased risk because the local road infrastructure can be poor.

We have been working with Cranfield University in the UK and other partners to develop a holistic approach that tackles internal risks as well as collaborating with others to address external risks, such as local road safety blackspots.

† To be independently assured by PwC in 2013.

“The biggest challenge we face is to scale up programmes cost-effectively.”

Future challenges

Achieving our targets to reach such significant numbers of people with hygiene messages and safe drinking water was always going to be challenging. While we have made progress, we recognise there is a considerable gap to fill to achieve our goal.

This is particularly true for Lifebuoy where we need to reach a further 881 million by 2015. We remain confident of our plans to scale up handwashing programmes at a faster rate over the next few years. Lifebuoy is focusing on the following priority areas to meet its target:

  • increasing the impact of rural outreach through partnerships and multi-brand programmes
  • creating larger partnerships with a pioneering approach to co-investment
  • rolling out a cost-effective and scalable programme to new countries
  • learning from evaluation studies to identify and roll out best practice
  • continuing to raise the profile of hygiene issues with governments, key opinion formers and wider communities.

To help more than a billion people improve their hygiene habits, we also recognise the need to develop a more holistic approach to the inter-related issues of water, sanitation and hygiene. We are looking at how we can promote affordable toilet provision and good toilet hygiene for millions while growing business for our Domestos brand. We are working with partners such as UNICEF and the World Toilet Organization to develop appropriate models to create and fulfil demand for toilets.